Active NPI 1184619595 Individual Practitioner Female Practitioner

Elise Diane Clark , FNP-BC

Nurse Practitioner • Delphos, OH

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Elise Clark, FNP-BC is a certified Nurse Practitioner practicing in Delphos, OH. With approximately 25 years of clinical experience since graduating from University Of Toledo College Of Medicine in 2001, Elise Clark delivers high-quality medical care to the local community at 607 ELIDA AVE.

Elise Clark maintains professional affiliations with Family Physicians Of Lima Inc, Lima Memorial Professional Corporation and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, established patient outpatient office visit, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

607 Elida Ave

Delphos, OH 458331736

Telephone 4199917805

Associated Practice Facility / Clinic

🏢 Lima Memorial Professional Corporation Facility NPI 1568314458

Medicare Profile & Education

Medical School

University Of Toledo College Of Medicine

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Delphos, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs +10.0 yrs vs City Avg

City Avg: 15.0 Yrs

State Avg: 9.8 Yrs

Regional Practice Density

2 Specialists

Practicing in Delphos, OH (4294 Statewide)

Telehealth Adoption Rate

50.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

67.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (25 Years) 25 Yrs

Delphos Specialty Average (15.0 Years) 15.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	79	79	$328.37	$104.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	68	57	$322.53	$103.59
99213 Established patient office or other outpatient visit, typically 15 minutes	50	39	$217.83	$73.12
99442 Telephone medical discussion with physician, 11-20 minutes	39	30	$225.27	$72.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	119	119	$216.00	$106.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	76	61	$244.00	$104.60
99213 Established patient office or other outpatient visit, typically 15 minutes	45	37	$159.00	$63.99
99442 Telephone medical discussion with physician, 11-20 minutes	35	30	$122.00	$63.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	161	161	$215.65	$108.88
99213 Established patient office or other outpatient visit, typically 15 minutes	75	64	$157.36	$72.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	54	$244.00	$106.24
99442 Telephone medical discussion with physician, 11-20 minutes	38	37	$122.00	$73.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	12	$130.00	$43.43
81002 Urinalysis, manual test	12	11	$38.00	$3.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	194	194	$149.69	$110.96
99213 Established patient office or other outpatient visit, typically 15 minutes	136	104	$118.00	$71.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	34	$181.00	$105.59
99442 Telephone medical discussion with physician, 11-20 minutes	27	24	$90.00	$76.66
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	20	20	$191.00	$140.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	19	$96.00	$33.03
81002 Urinalysis, manual test	17	14	$28.00	$3.48
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	13	13	$47.00	$11.72
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$185.00	$141.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	175	131	$111.83	$61.87
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	134	134	$129.00	$96.92
J0696 Injection, ceftriaxone sodium, per 250 mg	48	12	$22.00	$0.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	32	$172.00	$91.02
81002 Urinalysis, manual test	23	20	$27.00	$3.47
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	22	20	$45.00	$11.46
G0009 Administration of pneumococcal vaccine	20	20	$41.00	$16.04
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$176.00	$140.09
90670 Pneumococcal vaccine for injection into muscle	13	13	$302.00	$228.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	225	166	$110.00	$61.10
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	119	119	$126.00	$96.07
J0696 Injection, ceftriaxone sodium, per 250 mg	109	27	$21.00	$0.56
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	98	97	$89.00	$36.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	48	$169.00	$89.93
81002 Urinalysis, manual test	48	37	$26.00	$3.41
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	38	33	$44.00	$13.65
G0009 Administration of pneumococcal vaccine	27	27	$40.00	$15.75
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	19	19	$150.00	$110.26
G0008 Administration of influenza virus vaccine	18	18	$41.00	$15.75
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	17	17	$55.00	$17.48
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	13	13	$178.00	$142.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	306	202	$106.98	$59.79
J0696 Injection, ceftriaxone sodium, per 250 mg	112	26	$20.00	$0.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	71	56	$164.00	$88.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	66	66	$122.00	$95.02
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	50	43	$43.00	$16.51
81002 Urinalysis, manual test	48	38	$25.00	$3.41
J1030 Injection, methylprednisolone acetate, 40 mg	21	12	$16.29	$6.64
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	18	18	$53.00	$17.48
G0008 Administration of influenza virus vaccine	18	18	$40.00	$19.30
94640 Inhalation treatment for airway obstruction or sputum production	18	13	$99.00	$14.73
G0009 Administration of pneumococcal vaccine	17	17	$39.00	$19.30
93000 Routine ekg using at least 12 leads including interpretation and report	14	14	$77.00	$13.82
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$173.00	$140.38
90670 Pneumococcal vaccine for injection into muscle	11	11	$287.00	$196.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	326	212	$105.00	$59.23
J0696 Injection, ceftriaxone sodium, per 250 mg	152	28	$18.03	$0.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	77	70	$162.00	$86.92
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	70	46	$41.00	$20.33
J1030 Injection, methylprednisolone acetate, 40 mg	44	24	$13.33	$5.70
81002 Urinalysis, manual test	33	28	$23.00	$3.17
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	32	32	$122.00	$93.93
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	26	26	$51.00	$17.48
G0008 Administration of influenza virus vaccine	26	26	$38.00	$23.76
93000 Routine ekg using at least 12 leads including interpretation and report	16	15	$75.00	$13.73
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$173.00	$139.15
G0009 Administration of pneumococcal vaccine	11	11	$37.00	$23.76

Medical Specialties & State Licenses

CMS Verified: 2026-04-29

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License OH APRN.CNP.06689

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

2360252 (OH)

Commercial Insurance / Payer ID Travelers/railroad Medica

500023896 (OH)

Commercial Insurance / Payer ID Medicare Ptan

9934001 (OH)

Hospital & Practice Group Affiliations

Family Physicians Of Lima Inc

2875 W Elm St, Lima, OH 458052510

Phone: 4199917805

Lima Memorial Professional Corporation

602 W Redskin Trl, Wapakoneta, OH 458959349

Phone: 4197385151

Secondary Practice Locations

2875 W Elm St

Lima, OH 458052510

Phone: 4199917805

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Joel Pohlman , NP-C

Nurse Practitioner - Family

NPI 1235725490

Nurse Practitioner (Certified)

Dr. Karri Krendl , MD

Family Medicine

NPI 1831183896

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location April 29, 2026

Registered at 607 ELIDA AVE, DELPHOS, OH 458331736 (Tel: 4199917805)

📍

Updated Business Mailing Address April 29, 2026

Registered at 1001 BELLEFONTAINE AVE, LIMA, OH 458042800

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2025

Nurse Practitioner (License #APRN.CNP.06689 in OH)

✅

NPI Profile Active April 29, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location April 29, 2016

Registered at 2875 W ELM ST, LIMA, OH 458052510 (Tel: 4199917805)

📍

Updated Business Mailing Address April 29, 2016

Registered at 2875 W ELM ST, LIMA, OH 458052510 (Tel: 4199917805)

👤

Provider Name / Credentials Updated April 29, 2016

Recorded as ELISE CLARK, FNP BC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2016

Nurse Practitioner (License #NP06689 in OH)

🟢

Initial NPI Registration & Enumeration September 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184619595

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 13, 2005

Last Update: April 29, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1001 Bellefontaine Ave

Lima, OH 458042800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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